Expanded endonasal approach: vidian canal as a landmark to the petrous internal carotid artery

Technical Note

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✓ The purpose of this study was to describe the technique used to safely identify the petrous carotid artery during expanded endonasal approaches to the skull base. A series of 20 cadaveric studies was undertaken to isolate the vidian artery and nerve and to use them as landmarks to the petrous internal carotid artery (ICA). Twenty-five consecutive paraclival endoscopic cases were also reviewed to determine the consistency of the vidian artery in vivo as an intraoperative landmark to the ICA. These data were then correlated with results from a separate study in which computed tomography scans from 44 patients were evaluated to delineate the course of the vidian canal and its relationship to the petrous ICA. In all 20 cadaveric dissections and all 25 surgical cases, the vidian artery was consistently identified and could be reliably used as a landmark to the ICA. The correlation between anatomical and clinical data in this paper supports the consistent use of the vidian artery as an important landmark to the petrous ICA.

Abbreviations used in this paper:CT = computed tomography; ICA = internal carotid artery; MR = magnetic resonance.
Article Information

Contributor Notes

Address correspondence to: Amin B. Kassam, M.D., Department of Neurosurgery, University of Pittsburgh School of Medicine, 200 Lothrop Street, PUH B-400, Pittsburgh, Pennsylvania 15213. email: kassamab@upmc.edu.

© Copyright 1944-2019 American Association of Neurological Surgeons

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